Coordination of benefits (COB) is confusing. Can you provide some examples for dual coverage with medical plans so I can get a better understanding of how benefits will be coordinated?
In most cases, once the deductibles are satisfied, the member will not have any further out of pocket expenses, unless limitations and/or maximums are met. If you seek services from out-of-network providers, you will be responsible for any charges in excess of the ODS maximum plan allowance (MPA). If you have secondary coverage through a non-ODS plan, please check with that plan’s insurance carrier on how they handle coordination of benefits. Please see below for sample scenarios. Example #1 An ODS member has dual medical coverage. The primary coverage is through ODS. The member is covered under OEBB Plan 3 with a $100 individual deductible/$300 family deductible. The secondary coverage is through the member’s spouse, ABC company, with a $500 individual deductible/$1,000 family deductible. The first $100 in eligible charges would apply to both deductibles. Once the $100 deductible is met on the OEBB/ODS plan, ODS would begin to pay benefits. Eligible charges would continue to apply to
Related Questions
- Coordination of benefits (COB) is confusing. Can you provide some examples for dual coverage with medical plans so I can get a better understanding of how benefits will be coordinated?
- Coordination of benefits is confusing. Can you provide some examples for dual coverage with medical plans so I can get a better understanding of how benefits will be coordinated?
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